Cardiac arrest & resuscitation
Confounders for prognostic accuracy of neuron-specific enolase after cardiac arrest: A retrospective cohort study
Authors' conclusion
NSE concentrations higher than 100 µg/L predicted poor neurological outcome with high specificity. An NSE less than 17 µg/L indicated absence of severe hypoxic-ischemic encephalopathy.
Study context
- Population
- Survivors 3 days after cardiac arrest; Neuron-specific enolase (NSE) and h-index measured 48–96 h after arrest
- Participants
- 356 survivors
- Outcome
- Prognostic accuracy (specificity, sensitivity) of NSE for poor neurological outcome (CPC 4-5)
- Follow-up
- Hospital discharge
Methodological detailscardiac arrest registry, Separate analyses with CPC 1-3 and CPC 1-2 as good neurological outcome
- Cardiac arrest registry
- Separate analyses with CPC 1-3 and CPC 1-2 as good neurological outcome
Main finding
As reported in the abstract
Prediction of poor neurological outcome (CPC 4-5) · NSE 48-96 hours after cardiac arrest; CPC at hospital discharge
| Group | Sensitivity | Specificity |
|---|---|---|
| NSE 60 µg/L, all samples | 73% (66-79%)Sensitivity on a scale from 0 to 100 percent | 92% (86-95%)Specificity on a scale from 0 to 100 percent |
| NSE 100 µg/L, all samples | 58% (51-65%)Sensitivity on a scale from 0 to 100 percent | 98% (95-100%)Specificity on a scale from 0 to 100 percent |
| NSE 100 µg/L, non-hemolytic | 55% (47-63%)Sensitivity on a scale from 0 to 100 percent | 99% (95-100%)Specificity on a scale from 0 to 100 percent |
Sensitivity
NSE 60 µg/L, all samples73% (66-79%)
NSE 100 µg/L, all samples58% (51-65%)
NSE 100 µg/L, non-hemolytic55% (47-63%)
Sensitivity on a scale from 0 to 100 percentSpecificity
NSE 60 µg/L, all samples92% (86-95%)
NSE 100 µg/L, all samples98% (95-100%)
NSE 100 µg/L, non-hemolytic99% (95-100%)
Specificity on a scale from 0 to 100 percentObservational data: associations, not effects.
Further findings
Confounders for elevated NSE with good neurological outcome
- Possible confounders: ECMO, malignancies, blood transfusions, acute brain diseases
NSE below 17 µg/L with CPC 5
- Patients with NSE <17 µg/L and CPC 5, all with plausible death causes other than hypoxic-ischemic encephalopathy
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Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Confounders for prognostic accuracy of neuron-specific enolase after cardiac arrest: A retrospective cohort study. Resuscitation. Published 6 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →